Psychiatry International

Background: Piperazines, synthetic compounds known for their stimulant and hallucinogenic effects, have gained prominence among novel psychoactive substances (NPS) and are frequently associated with adverse psychiatric outcomes, including psychosis. Methods: A systematic review of the literature available up to 23 May 2024 was conducted, using the PubMed, Scopus, and Web of Science databases, in addition to the related gray literature, utilizing the following search strategy: “piperazines” AND (“psychosis” OR “hallucination” OR “delusion” OR “schizophrenia” OR “delusional” OR “schizoaffective”) NOT review NOT animal. Data collection adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research methods were registered with PROSPERO (CRD42024549204). Results: Out of a total of 4547 articles identified, 4 met the inclusion criteria. We observed an important relationship between piperazine abuse and the onset of acute psychotic episodes, marked by symptoms such as paranoia, auditory, and visual hallucinations. Conclusion: The complex polyreceptor action mechanism of piperazines may explain these psychopathological effects, similar to those observed with other NPS. Although studies confirm a link between piperazine use and psychosis, data on long-term outcomes are limited. Recovery is common following cessation and treatment. Further research into the effects of piperazine abuse and the development of specific treatment protocols for substance-induced psychosis is necessary. Full article

Suicidal ideation is a process that is intertwined with suicidal behavior. It begins with the formation of an idea about whether it is worth continuing to live, an idea that can evolve and trigger a series of actions ranging from planning to the execution of the suicidal act. This is a descriptive observational study based on numerical measurements with its respective statistical analysis that established the behavioral patterns of the phenomenon studied. The research proposal was approved by the research committee of the Faculty of Medicine and Surgery, URSE; data collection was performed through the instruments: Beck Suicidal Ideation Scale, Beck Depression Inventory, Abbreviated Scale of School Bullying Questionnaire, Drug Dependence Identification Questionnaire, and Family Apgar. The prevalence of suicidal ideation was 5.4%; 19.7% of the medical students have been victims of bullying in any form; 22.2% reported regular use of alcohol, tobacco, drugs, and other addictive substances; in addition, 17.7% had mild family dysfunction, moderate in 9.9% and severe with 15.3%; depression was recorded to a mild degree with 6.4%, followed by moderate in 1.5% of cases. Suicidal ideation among medical students is of concern; these problems must be addressed comprehensively, promoting a supportive environment that promotes the mental health and well-being of medical students. Full article

Depression is one of the most common disorders worldwide, including in Mexico. Engagement coping and optimism promote mental health, so understanding the mediation of optimism between coping strategies with depression helps to identify the psychological resources that young people can use to mitigate depression. This study aims to test the direct and indirect effects of four coping strategies through three optimism factors on affective depression in a mediator path model in young people. In a cross-sectional study, 848 young Mexican people completed the evaluation instruments of the Trait Depression Inventory, Mexican Optimism Scale (MOS), and Coping Strategies (CSI-SF). Moderate mediation analysis was performed. Optimism and coping strategies significantly predict depression. Furthermore, optimism mediated the association between problem-focused engagement coping and depressive symptoms. Problem- and emotion-focused coping and optimism protect young people from depression. Likewise, young people with greater optimism use problem-focused engagement coping, which reduces depressive symptoms. Psychosocial interventions that promote positive outlook, affective resources, and hope combined with engagement coping strategies are suggested for the management of depression. Full article

This study explores the complex relationships between various dimensions of eating behavior regulation and their impact on bulimia and food preoccupation using network analysis. The objective was to identify key regulatory mechanisms that influence bulimic behaviors and food-related obsessions. The study analyzed data from 659 participants, recruited via convenience sampling, using scales that measured intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, amotivation, and bulimia and food preoccupation. Pearson’s correlation analysis revealed significant negative relationships between bulimia and both introjected regulation (r = −0.345, p < 0.001) and external regulation (r = −0.298, p < 0.001). Network analysis highlighted identified regulation and introjected regulation as central nodes with substantial influence over bulimia and food preoccupation, while integrated regulation demonstrated a significant indirect impact. The perception that food is necessary for life and energy, as well as for nourishment, enjoyment, social and cultural relationships, and emotional comfort, was further demonstrated using qualitative thematic analysis. The aforementioned results emphasize the pivotal functions of identified and introjected regulatory mechanisms in shaping conduct associated with food preoccupation and bulimia. According to the study, specific therapies that target these mechanisms may be essential for lowering bulimic symptoms and encouraging better eating practices. Full article

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style questionnaire (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of these decision-making style questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies, respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (0.50), and Hypervigilance, Buck-passing, and Procrastination with Avoidant (0.45, 0.52, and 0.60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of 0.96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct. Full article

Life satisfaction has been identified as a cognitive indicator of subjective well-being as well as self-image, and these become fundamental factors in the development of young people during adolescence. Therefore, the aim of this study is to explore the possible associations between life satisfaction and self-perceived physical fitness in adolescents from a region of southeastern Spain. In addition, the aim is to evaluate the influence in these associations of gender and urban or rural living environment. For this purpose, a cross-sectional study was carried out with 688 secondary school students (12 to 16 years old) in which the “Satisfaction with Life Scale” and the “Visual Analogical Scale of Physical Fitness Perception for Adolescents” were applied. The associations of the scales were analyzed through Spearman’s Rho test and the consistency of the scales through Cronbach’s Alpha. In addition, a linear regression analysis was carried out to evaluate the contributions of the different dimensions of physical fitness to the life satisfaction of the students. Medium, positive and significant correlations were found between the dimensions of physical fitness and life satisfaction. Similarly, the regression model showed that general physical fitness and endurance explained 20% of the variance in life satisfaction. Therefore, educational interventions and policies must take this information into account when designing and developing actions aimed at improving these cognitive factors. Full article

Background: A wide range of conditions, including mixed depressive symptoms, hyperactivity, cognitive impairment (CI) might be expressions of Bipolar Spectrum Disorder (BSD) according to the neo-Kraepelinian perspective, even in advanced age. CI, which has a high prevalence in the elderly population, when it occurs in comorbidity with depression further hinders therapy response and functional ability. The present study aims to explore risk factors associated with CI in elderly individuals experiencing a depressive episode during lockdown a period marked by significant stressors and rhythm disruption. Methods: A case-control study analyzed data from a previous RCT (secondary analyses) on elderly individuals living at home, assessing depressive symptoms, cognitive performance, hyperactivity, and hypertension before (T0) and during lockdown (T1). Results: Participants with lower pre-pandemic cognitive performance were more prone to lockdown depression compared to those with higher baseline function (F = 6.074; p = 0.016). Among those experiencing lockdown depression without prior depression, those with low cognitive performance were more prevalent than the control group without depression (OR = 11.8; p = 0.015). Conclusion: This study highlights a potentially vulnerable subgroup within the elderly population that requires targeted interventions and support during stressful events. Future research should explore the underlying mechanisms linking cognitive decline and depression in older adults, particularly those with a possible bipolar spectrum predisposition. Full article

This study focused on mental health and fatigue in elite university student-athletes competing in badminton at the national level, comparing them with control university students and examining related factors. Among university athletes, anxiety and depression showed a moderately negative correlation with life satisfaction outside of sports, as determined by partial correlation tests adjusted for fatigue. Athletes demonstrated a 47% rate of anxiety and a 30% rate of depression. These values showed no significant difference from those of the anxiety (29%) and depression (21%) rates in a non-athlete university student sample. In addition, this study suggested that the evaluation of fatigue using a checklist of individual strength might produce low reliability and validity for elite university student-athletes in badminton. These exploratory findings highlight the importance of focusing on athletes’ overall life satisfaction and suggest the potential need for effective mental health interventions beyond sports. However, because of the exploratory nature of this study and the small sample size, further research is necessary to confirm these results. Full article

Cultivating an eudaimonic lifestyle benefits mental health. However, it is not known under which circumstances the benefits of eudaimonia are the most pronounced. This cross-sectional study aimed to examine psychological needs (autonomy, competence, and relatedness) as the moderators of the effects eudaimonia has on mental health (general mental health, positive and negative mental health). In total, 328 young adults took part in this study, of which 36.6% were males, whose ages ranged between 18 and 30, with a median of 19 years (SD = 1.32). Questionnaires were used to measure eudaimonia (The Eudaimonia Scale from The Hedonic and Eudaimonic Motives for Activities), psychological needs (The Basic Psychological Needs Scale), and mental health (The Mental Health Inventory). To analyze the data, hierarchical regression analyses and analyses of variance have been performed. The results revealed that of all psychological needs, only the need for relatedness moderated the relationship between eudaimonia and general mental health and eudaimonia and negative mental health. Individuals with high eudaimonia and a highly satisfied need for relatedness had good general mental health and fewer mental health disturbances. The findings suggest that if one practices meaningful behaviors, the positive change in the mental health domain is greatest when those actions benefit not only this individual but others as well. Full article

Background: Depression is a serious and debilitating condition with a rising prevalence. Anhedonia, a core symptom of depression, is notably significant and the second most weighted factor among the non-somatic concerns of depression, following depressed mood. The interaction between technology use, mood, emotions, depression, and anhedonia is a critical area of investigation. Aim: This study aims to develop a comprehensive Systematic Review Protocol to examine the emotional effects of Internet-related behavior in young people. Methods: A systematic review protocol was developed following PRISMA guidelines for systematic reviews. The research question was formulated according to the PICOS framework. The search was conducted using PubMed/Medline, Cochrane Library, Embase, Scopus, and PsycInfo, supplemented by gray literature sources via Google Scholar. The methodological quality and risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) framework. This systematic review protocol was registered on the Open Science Framework with the registration DOI: 10.17605/OSF.IO/SHNJU. Conclusions: The findings of this systematic review are expected to provide new evidence on the correlations between depression, Internet addiction, and anhedonia, contributing to the development of targeted intervention strategies and improving the understanding of young peoples’ emotional well-being. Full article

Suicidality poses a significant public health threat and stands as a leading cause of death and disability. Aside from committed suicides, a substantial portion of suicidal behaviors comprises suicide attempts and suicidal ideation. These events may be characterized by a non-fatal outcome, shedding light on the possibility of recurrence. The objectives of the present study were to assess hospitalization rate trends related to any suicidal event and to elucidate the risk factors associated with recurrent suicidal behaviors. In this population-based study, an observational descriptive analysis was conducted on all hospital discharge forms (HDRs, Italian SDO) registered for the residents of the Veneto Region from 2012 to 2021. Cases of attempted suicide (AS) and suicidal ideation (SI) were defined according to ICD coding. Age-standardized hospitalization rates were computed with the direct method. Join Point Regression was used to assess the significance of variations in trends. Factor risks for the reiteration of suicidal behaviors were assessed by multivariate logistic regression. Higher prevalence of SI occurred among individuals under 40 years of age and those affected by psychiatric disorders. Conversely, among individuals aged 60 and above, AS was more common. SI turned out to be associated with a higher likelihood of reiteration compared to AS. Individuals suffering from personality disorders and those with a history of AS as index case exhibited increased risk for the reiteration of AS. Females, younger individuals, and individuals experiencing SI as first episode were instead identified as more likely to repeat this form of suicidal behavior. Contemporary economic and environmental crises, a recent pandemic, and numerous conflicts represent significant additional menaces to mental well-being. Our analysis highlights a concerning positive trend in suicide attempts and ideations, underscoring the imperative for Public Health Systems to implement targeted preventive strategies and mental health promotion campaigns. In the absence of structured suicide registries, we demonstrated that HDRs can serve as an invaluable foundation for preventionists to address the phenomenon and strategically plan interventions. Full article

This study investigates the relationship between semantic memory and social cognition in schizophrenia. The sample included 50 individuals with schizophrenia (mean age 42.54, SD 9.98; 14 women, 36 men) and 30 controls (mean age 42.06, SD 12.50; 6 women, 24 men). Semantic memory was assessed using verbal fluency and the Camel and Cactus Test, while social cognition was evaluated through the Face Test and the Hinting Task. The schizophrenia group showed significantly lower performance in both semantic memory (semantic fluency: t(78) = 7.77, p < 0.007, δ = 1.79; Camel and Cactus Test: t(78) = 5.37, p < 0.007, δ = 1.26) and social cognition (Face Test: t(78) = 5.94, p < 0.007, δ = 1.34; Hinting Task: t(78) = 7.79, p < 0.007, δ = 1.79). Strong correlations were observed between the Camel and Cactus Test and social cognition measures (Face Test: r = 0.63, p < 0.005; Hinting Task: r = 0.54, p < 0.005). Regression analyses indicated that the Camel and Cactus Test significantly predicted social cognition performance independent of symptomatology, explaining 53% of the variance in the Face Test and 54% in the Hinting Task. This study provides new insights into the cognitive underpinnings of schizophrenia, emphasizing the need for further research to explore these relationships and their implications for cognitive models and therapeutic interventions. Full article

Financial threat refers to fear, unease, and uncertainty regarding an individual’s present or forthcoming financial state. Despite consistent findings indicating that financial threats are harmful to individuals’ behaviors and mental health, their impacts remain largely unexplored in the context of organizational behaviors. This study examined whether and how financial threats are detrimental to various aspects of employees’ performance, including task, contextual, and counterproductive performance. A sample of 165 working adults in Malaysia responded to an online survey consisting of the Financial Threat Scale, Perceived Stress Scale, and Individual Work Performance Questionnaire. Confirmatory factor analysis supported the structure of the measurements, although some items were eliminated. Pearson correlation analysis showed that financial threats had a positive relationship with perceived stress and counterproductive performance. Meanwhile, perceived stress was negatively related to task performance and positively associated with counterproductive performance. Finally, structural equation modeling revealed that perceived stress mediates the relationship between financial threats and counterproductive performance. These findings illuminate the underlying mechanisms by which financial threats impact employees’ job performance. They also highlight the importance of addressing resource depletion’s effects on the mental health of working adults. The implications of these findings for organizational management and employee well-being are discussed. Full article

Background: Sex work remains a contentious and marginalized aspect of society, with sex workers facing a myriad of challenges that impact their mental health and well-being. Objective: This review explores, reviews, and examines the psychiatric challenges encountered by sex workers daily and seeks to identify key gaps in the current research and highlight areas of future intervention and support. Methodology: This study followed five stages of the integrative review suggested by Whittmore and Knafl. The identification of the problem, literature search, data evaluation, data extraction, analysis, and presentation of results were the five stages of the integrative review that were carried out. This review examined English-language publications from 2010 to 2023 that discussed the mental health issues that sex workers experienced. Furthermore, this study excluded publications that were published before 2010, articles written in languages other than English, publications whose complete texts could not be retrieved, and works that did not address the mental health problems that sex workers encounter. For their initial search, the writers employed electronic databases like PubMed, Scopus, Psych-Info, Google Scholar, Science Direct, and Medline. The search terms were as follows: ‘sex work’, ‘sex workers’, ‘prostitution’, ‘mental health’, ‘psychiatric challenges’, ‘stigma’, Risk factors’, and ‘barriers’. Results: Following the critical appraisal, out of 150 studies, only 34 studies were chosen for analysis. Using Cresswell’s Tesch method, two themes emerged from this study: (1) mental health challenges faced by sex workers and (2) primary risk factors contributing to their mental health challenges. Conclusions: Moreover, addressing the psychiatric challenges faced by sex workers requires a multifaceted approach that acknowledges the intersectionality of factors influencing sex workers’ mental health outcomes, thus also highlighting the imperative for tailored interventions and support systems to promote their well-being. Full article

A child’s autism diagnosis is life-changing for their parents, due to the complex and long-term nature of the condition. Furthermore, research about the increased prevalence of autism suggests that more parents are being affected globally. However, limited studies have investigated parents’ lived experience of their child being diagnosed with autism. This study aimed to explore the first-hand experience and concerns of parents when their child has been diagnosed with autism. The study employed a qualitative, exploratory design. Parents of a child who had received an autism diagnosis at least 12 months prior were invited to a video interview. Eleven parents participated in an hour-long interview. The interviews were transcribed, and an inductive reflexive thematic analysis was performed. The analysis resulted in four main themes: “Shock and control”, “A thousand little conversations”, “Put your own oxygen mask on first”, and “Reforged identities”, orientating around the period surrounding diagnosis, ongoing communication requirements, the need for self-care and reorientation of identity. These findings identify areas of heightened concern for parents and provide professionals with practical insight when evaluating their engagement approaches with these groups of parents. Findings can help psychologists, therapists, educators and parents themselves to identify strategies to support the well-being of parents who have an autistic child. Full article

The main objective of this study was to assess the positive emotions and the quality of life among patients on methadone maintenance therapy (MMT) as well as their associated factors. This is a cross-sectional survey study. Participants undergoing MMT in two major Malaysian hospitals responded to the sociodemographic and clinical information sheet, the Positive Emotion Rating Scale (PERS), and the World Health Organization Quality of Life (WHOQOL)-BREF. Most of the participants (N = 154; mean age = 43.8 ± 9.0 years) were male (97.4%) and Malays (75.3%). Slightly more than half (50.6%) scored above 30 on the Positive Emotion Rating Scale. There was a significant association between being ethnically Malay, married, and employed and positive emotions. After adjusting for potential confounding factors, having positive emotions predicted a better overall, physical, and psychological quality of life. Being non-diabetic also significantly predicted a better quality of life in the overall domain, whilst not being married and family history of mental illness significantly predicted a lower overall and psychological quality of life. Positive emotions significantly improve patients’ quality of life in the MMT program, suggesting the inclusion of positive emotions in a holistic treatment approach. Full article

Mental health and emotions are two fundamental aspects of our overall well-being. Good mental health can help us manage and regulate our emotions in a healthy way. Similarly, emotions can affect our mental health if we are not able to recognize, express, and manage our emotions in a healthy way. The present research aims to conduct a thematic analysis on the presence of emotions in X (formerly known as Twitter) discourse on mental health. A total of 455 tweets dealing with mental health have been collected in this study. The results show that the presence of emotions in mental health discourse is quite limited compared to the non-use of emotions. Regarding those who do use emotions, love and anxiety stand out. When users do not address emotions, they do argue certain variables such as stress, depression, suicide, or job insecurity. It is argued that emotions do not receive the attention and importance they deserve in the field of mental health. If emotions are not properly recognized, understood, or managed, there may be several risks for society in general. Therefore, the need to promote emotional education with the intention of increasing people’s well-being and mental health is raised. Full article

Background: The ability of scientists and clinicians to detect the therapeutic needs of patients with brain damage has increased in recent years. In this sense, many studies have signaled that individuals tend to experience an increase in irritability after suffering brain damage, with some patients even showing sudden aggressive outbursts. This increase in anger expression in these patients could be explained by executive functioning alterations (or executive dysfunctions), given their role in goal-oriented behaviors, along with emotional dysregulations such as alexithymia (e.g., difficulties recognizing and verbalizing feelings) and anger rumination (e.g., tendency to recall thoughts regarding experiences of frustration or anger). Therefore, it is essential to understand the mechanisms that contribute to and/or facilitate anger expression in patients with brain damage. Methods: In this regard, the main objective of this study is to assess whether executive dysfunctions (assessed with the Frontal Systems Behavior Scale) would explain anger expression (measured with the Reactive and Proactive Aggression Questionnaire) in patients with brain damage (n = 23; mean age: 56.61 ± 10.68; 57% men) compared to controls (n = 24; mean age: 60.96 ± 9.25; 33% men), paying special attention to potential moderators of this association such as alexithymia (analyzed with the Toronto Alexithymia Scale-20) and anger rumination (assessed with the Anger Rumination Scale). Results: The results of the current investigation led us to conclude that anger expression in patients with brain damage was partly explained by executive dysfunction, especially in those patients who scored high in alexithymia. This model was not significant among controls. Conclusions: Thus, we highlight the importance of targeting certain psychological alterations, such as alexithymia, when implementing psychotherapeutic programs as an adjuvant to cognitive training focused on cognitive deficits (e.g., executive dysfunctions). This, in turn, would support the full recovery of individuals who have experienced brain damage. Full article

Background: As the most widespread eating disorder in the world now, binge eating disorder (BED) is a mental condition characterized by recurrent periods of excessive food consumption and an inability to regulate one’s portion sizes. The utilization of a bupropion–naltrexone (NB) combination has been suggested as a potential therapeutic approach for BED. Assessing the effectiveness of NB in the treatment of BED and its accompanying obesity is the purpose of this research. Methods: A comprehensive search was conducted in order to obtain any pertinent articles. PubMed, Scopus, Web of Science, and Cochrane Clinical Trials were consulted against in the databases that were searched. In our final meta-analysis, we incorporated interventional or observational studies that documented the effects of NB therapy for binge eating in adults. We also examined the difference in the mean change between the NB and placebo groups, as well as the disparity in outcomes before and after treatment. Results: This study shows that the use of an NB combination is associated with a statistically significant reduction in the weight, BMI, and Binge Eating Scale (BES) of the patients compared to their weight before treatment with MD: −8.52 (95% CI: −10.01–−6.94, p < 0.00001), MD: −4.95 (95%CI: −9.72–−0.17, p = 0.04), and MD: −7.66 (95%CI: −14.36–0.96, p = 0.02), respectively. The absolute mean change was statistically significantly higher in the drug combination group compared to the placebo group. Conclusions: NB showed efficacy in the improvement of the weight and psychiatric symptoms associated with BED and this provides a promising treatment option. Full article